double-edged sword represented by funding formulas. He says his commu- nity must maintain a minimum of 15 TB cases to receive full funding for TB ser- vices. After Hurricane Ike, GCHD’s level fell below the 15-case threshold, causing the district to lose its two TB contracts, which provided $126,000. “After consulting with DSHS, we
received general revenue funds of $100,000 for TB,” Dr. Guidry said. He says funding formulas for disease
control in Texas should include two allo- cations — one that provides for disease prevention and surveillance and one that pays for treatment. The former amount would be fixed, and the latter amount would vary by community, depending on the number of disease cases. He says the DSHS Public Health Funding and Policy Committee may consider this method for funding formulas. “The way the funding formula is set
up now takes an all-or-nothing approach. If we don’t have a certain number of cas- es of TB, for example, we lose all fund- ing, including monies for prevention,” he said.
Massive spreadsheets detail contracts
DSHS has with local health departments. Making sense of the services each con- tract covers requires use of a decoding document that identifies each program and provides a description. For example, when sifting through DSHS funding spreadsheets, the abbreviation IMM/LO- CALS is a common program identifica- tion that pops up. It stands for contracts covering immunization branch activities. The decoding document elaborates to
explain these contracts provide immuni- zation branches with funding for essen- tial public health services in collabora- tion with local health departments “to prevent and control the transmission of vaccine-preventable diseases in children, adolescents, and adults, with emphasis on accelerating strategic interventions.” Adding to the complexity, some con-
tracts renew annually and cover ongoing public health programs, such as immuni- zations and STDs. Others are for short- term projects, such as CDC’s pandemic flu planning or its PHER funds, which ran out in July. Additionally, funding spreadsheets provide a snapshot in time,
Online Lab Results.
Online access to DSHS Laboratory results and Newborn Screening Remote Data Services is now available to all Texas Health Steps medical providers. Online lab and newborn screening results will help you minimize common errors related to specimen collection, reduce the need for re-collection and re-testing, and cut the waiting time for results.
To access these services, visit
www.dshs.state.tx.us/lab/remoteData.shtm
Taking New Steps February 2012 TEXAS MEDICINE 45
as funds for the current year are always subject to change. Chris Van Deusen, DSHS assistant press officer, says it’s possible some contracts haven’t yet been executed, or health departments may opt out of some programs or add new programs. “Bottom line, the raw numbers may
not hold all the answers,” he said. Dr. Guidry says it’s possible for a
health department to have several con- tracts that fund specific program servic- es that may or may not be relevant to a community. For instance, not all commu- nities have a high incidence of HIV. In addition, with every contract from
DSHS, health departments must under- go an audit. Dr. Guidry says DSHS dis- patches several employees who review one contract at a time for compliance, typically requiring several visits for each contract audit. “Generally, not all of our contracts
with the state renew automatically, so we have to write grants to renew them.
Some grants are by calendar year, local fiscal year, or state fiscal year. The level of complexity is inefficient,” Dr. Guidry said.
He says the DSHS Public Health
Funding and Policy Committee will ex- plore ways to fund local health depart- ment services. One option the committee may consider, he says, is providing one block grant to each local public health entity. “This method would allow depart-
ments to provide relevant services at the community level in an efficient way by eliminating the need for multiple audits and grant applications,” Dr. Guidry said.
Editor’s Note: This is the second of Associ- ate Editor Crystal Conde’s two-part exami- nation of public health in Texas. The first part in the January 2012 issue of Texas Medicine detailed the Lubbock medical community’s efforts to preserve public health services within the Lubbock Health Department.
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